Many physicians put their patients on special diets to treat a disease. Not me. I strongly believe that for older patients, these restrictive diets have questionable value and may even cause harm.

Emerging evidence backs me up. Our studies at St. Louis University and studies at Stanford University have shown that the American Diabetic Association diet is not appropriate for residents of nursing homes.

In addition, recent studies have clearly shown that for most people, very low salt diets are unnecessary. Two recent studies in the Journal of the American Medical Association have suggested that excessive reduction in salt intake may increase heart disease and death. For most people, that means they should avoid sprinkling salt on their food. Even for those on dialysis, whose bodies are among the most vulnerable to effects of salt, excessive salt restriction is unnecessary. Their salt intake can be corrected by a longer dialysis time.

Low cholesterol diets have not been shown to have a positive effect on health, either. Older patients who are frail and have low cholesterol tend to have worse outcomes than those with high cholesterol. A fun fact to note: one man whose cholesterol was low ate more than 20 eggs a day.

For many years now, less restrictive diets has been recommended for those in nursing homes. Our research has found that diabetic residents of nursing homes can enjoy cake, candy and ice cream in moderation.

Therapeutic diets are often unpalatable and may make eating unbearably difficult and unpleasant. Particularly for those who reside in nursing homes, their quality of life and enjoyment of food is more important than any possible therapeutic effect of a diet. In addition, weight loss, which can be triggered by an unpalatable diet, is associated with major health problems and even death in older patients.

The bottom line: Older adults should eat a balanced diet of foods they enjoy and avoid special therapeutic diets.

SLUCare physician John Morley is director of geriatrics at St. Louis University and a geriatrician at St. Louis University Hospital and Des Peres Hospital. Email him at morley@slu.edu. The Aging Successfully column for seniors rotates each week with XX Files, a women's health column.